NPI | 1750864856 |
---|---|
Former Name | LESA MARIE HOGEBOOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 18731) |
Enumeration Date | 2018-09-13 |
Last Update Date | 2019-02-27 |